Use of Cystatin C to Assess Kidney Function

Cystatin C: CKD Progression and Complications (MESA and CHS)⁵

August 2011

This slide shows data from close to 12,000 other participants in 2 studies designed to assess cardiovascular outcomes over time. Once again, the investigators also looked at predictors of kidney function in their cohorts. In this study an elevated cystatin C predicted all cause mortality and cardiovascular disease, while creatinine alone did not. Furthermore, an increase in cystatin C was a much stronger predictor of future kidney failure than creatinine alone. An increase in creatinine together with cystatin C markedly increased the risk of kidney failure, close to 24 times baseline. Taken together, both of these large studies suggest that cystatin C is particularly good at identifying persons at risk for progression of chronic kidney disease, as well as future cardiovascular events and even mortality.

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Jump to section:

• Introduction
• A Case
• Questions
• What do the kidneys do?
• Why Measure Renal Function?
• How Is Chronic Kidney Disease (CKD) Defined?
• Stages of Chronic Kidney Disease
• Laboratory Assessment of Kidney Function: What Can We Measure?
• Creatinine as a Marker of GFR
• Creatinine as a Marker of GFR: It Works But...
• How Can We Turn the Serum Creatinine Into a Better Estimate of GFR?
• Revised eGFR Equation (ID-MS version)
• eGFR Equation Works, But it's Not Perfect
• What About Cystatin C?
• Mayo Renal Laboratory Cystatin C By Particle Enhanced Turbidometric Immunoassay (PETIA)
• Comparison To Current Nephelometric Assay (PENIA) Reveals 23% Bias
• Cystatin C PENIA Assay Shift (19%)
• Cystatin C eGFR Using Published Equation* Performs Well³
• Cystatin C Equations Categorize Patients Slightly Better Than MDRD eGFR
• Cystatin C Reference Range
• PETIA Cystatin C Reference Range
• Cystatin C: Useful To Confirm Those At Risk Of CKD Progression And Its Complications (REGARDS)⁴
• Cystatin C: CKD Progression and Complications (MESA and CHS)⁵
• Cystatin C in the Acute Hospitalized Setting⁶
• Back to Our Patient
• Potential Interventions
• Conclusions
• References
• Questions?